Prepared Citizens

Do unto others as you would have them do unto you.

  • Previous Posts

  • Michael Osterholm Quotes:

    “What we need to be doing now is the basic planning of how we get our communities through 12 to 18 months of a pandemic.”

    “Ninety-five out of 100 will live. But with the nation in crisis, will we have food and water? Are we going to have police and security? Will people come to work at all?”

    “It's the perfect setup. Then you put air travel in and it could be around the world overnight.”

    “We can predict now 12 to 18 months of stress of watching loved ones die, of wondering if you are going to have food on the table the next day. Those are all things that are going to mean that we are going to have to plan -- unlike any other crisis that we have had in literally the last 80-some years in this country.”

  • US Health and Human Services

    Secretary Michael Leavitt

    "If there is one message on pandemic preparedness that I could leave today that you would remember, it would be this:

    Any community that fails to prepare with the expectation that the federal government or for that matter the state government will be able to step forward and come to their rescue at the final hour will be tragically wrong,

    not because government will lack a will, not because we lack a collective wallet, but because there is no way that you can respond to every hometown in America at the same time."
  • Joseph C. Napoli, MD of Resiliency LLC

    "I think a new meaning is evolving for resiliency and resilience.

    In some contexts the words are being used to mean the strength to resist being impacted by an adverse event rather than either the “capacity to rebound” or “act of rebounding” from adversity.

    Therefore, resiliency and resilience appear to be assuming the meaning of fortitude, that is, “the strength or firmness of mind that enables a person to encounter danger with coolness and courage or to bear pain or adversity without despondency” as defined in the Webster’s Third New International Dictionary.

    If so, we are coming full circle with science accepting a religious moral virtue – fortitude – as written in the Bible’s Book of Wisdom"

  • Faith Based Resources

    John Piper
    Jonathan Edwards
    Pink-Saving Faith
    Pink-Christian Ethics

    "Examine yourselves, whether ye be in the faith; prove your own selves"
    (2 Corinthians 13:5).

    Why Faith Groups Must Care

    When the Darkness Will Not Lift by John Piper


    Be Not Afraid
    Overcoming the fear of Death
    by Johann Christoph Arnold

    While I am not a professional journalist, I do embrace the code of ethics put forth by the Society of Professional Journalists and the statement of purpose by the Association of Health Care Journalists and above all else I strive to "do no harm".

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  • Definitions

    from Wikipedia

    Pandemic Influenza

    An influenza pandemic is an epidemic of the influenza virus that spreads on a worldwide scale and infects a large proportion of the human population.

    In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in recent history.

    Pandemics can cause high levels of mortality, with the Spanish influenza being responsible for the deaths of over 50 million people.

    There have been about 3 influenza pandemics in each century for the last 300 years. The most recent ones were the Asian Flu in 1957 and the Hong Kong Flu in 1968.

    Seasonal Influenza

    Flu season is the portion of the year in which there is a regular outbreak in flu cases.

    It occurs during the cold half of the year in each hemisphere.

    Flu activity can sometimes be predicted and even tracked geographically. While the beginning of major flu activity in each season varies by location, in any specific location these minor epidemics usually take about 3 weeks to peak and another 3 weeks to significantly diminish.

    Individual cases of the flu however, usually only last a few days. In some countries such as Japan and China, infected persons sometimes wear a surgical mask out of respect for others.

    Avian (Bird) Flu
    Avian influenza,

    sometimes Avian flu, and commonly Bird flu refers to "influenza caused by viruses adapted to birds."

    "Bird flu" is a phrase similar to "Swine flu", "Dog flu", "Horse flu", or "Human flu" in that it refers to an illness caused by any of many different strains of influenza viruses that have adapted to a specific host.

    All known viruses that cause influenza in birds belong to the species: Influenza A virus.

    All subtypes (but not all strains of all subtypes) of Influenza A virus are adapted to birds, which is why for many purposes avian flu virus is the Influenza A virus (note that the "A" does not stand for "avian").
    Adaptation is non-exclusive.

    Being adapted towards a particular species does not preclude adaptations, or partial adaptations, towards infecting different species.

    In this way strains of influenza viruses are adapted to multiple species, though may be preferential towards a particular host.

    For example, viruses responsible for influenza pandemics are adapted to both humans and birds.

    Recent influenza research into the genes of the Spanish Flu virus shows it to have genes adapted to both birds and humans; with more of its genes from birds than less deadly later pandemic strains.

    H5N1 Strain

    Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species.

    A bird-adapted strain of H5N1, called HPAI A(H5N1) for "highly pathogenic avian influenza virus of type A of subtype H5N1", is the causative agent of H5N1 flu, commonly known as "avian influenza" or "bird flu".

    It is enzootic in many bird populations, especially in Southeast Asia. One strain of HPAI A(H5N1) is spreading globally after first appearing in Asia.

    It is epizootic (an epidemic in nonhumans) and panzootic (affecting animals of many species, especially over a wide area), killing tens of millions of birds and spurring the culling of hundreds of millions of others to stem its spread.

    Most references to "bird flu" and H5N1 in the popular media refer to this strain.

    As of the July 25, 2008 FAO Avian Influenza Disease Emergency Situation Update, H5N1 pathogenicity is continuing to gradually rise in wild birds in endemic areas but the avian influenza disease situation in farmed birds is being held in check by vaccination.

    Eleven outbreaks of H5N1 were reported worldwide in June 2008 in five countries (China, Egypt, Indonesia, Pakistan and Vietnam) compared to 65 outbreaks in June 2006 and 55 in June 2007.

    The "global HPAI situation can be said to have improved markedly in the first half of 2008 [but] cases of HPAI are still underestimated and underreported in many countries because of limitations in country disease surveillance systems".

    Pandemic Severity Index

    The Pandemic Severity Index (PSI) is a proposed classification scale for reporting the severity of influenza pandemics in the United States.

    The PSI was accompanied by a set of guidelines intended to help communicate appropriate actions for communities to follow in potential pandemic situations. [1]

    Released by the United States Department of Health and Human Services (HHS) on February 1, 2007, the PSI was designed to resemble the Saffir-Simpson Hurricane Scale

    From the Massachusetts Health and Human Services


    refers to separating people who are ill from other people to prevent the spread of a communicable disease.


    refers to separating and restricting the movement of people who have been exposed to a communicable disease and are not yet ill.
  • Additional Information

    Creative Commons License
    Prepared Citizens by Catherine "Jackie" Mitchell is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.
    Based on a work at

    The posts on this site are subject to change. Mostly due to errors in spelling or grammar. I never said I am a professional journalist. I have new appreciation for the job that they do. Also, not all comments made by others will make it onto this site. Comments that advertise a commercial product do not get posted most of the time.

    View blog top tags
  • standingfirm

The Importance of Sentinels – Utilizing Technology

Posted by preparedcitizens on March 13, 2008

Hat tip to Siam at P4P

Making technology work for us!

From 2002 until the present, the CDC has spent in excess of $5 billion to improve preparedness and response in the event of a major disease outbreak or a bioterror event.

The CDC Influenza Pandemic Plan outlines the agency’s information technology plans and systems that will support a nationwide response to an outbreak of a novel flu strain pandemic utilizing real-time data exchange and information management. Biosense provides analytical results to users approved to access data for their jurisdiction in a national early event detection and situational awareness system.  

Biosense, the CDC’s high tech system for surveilling the cases of influenza like illnesses gathering data from among 400 of 5600 participating U.S. hospitals and there is a current request for wider participation in the system from the states themselves in order to build a nationwide sentinel system.

Data Sources

Data is received into the system from 3 main sources and it is analyzed daily. Historical data is also available.

  • Department of Defense Military Treatment Facilities – approximately 700 DoD medical facilities collected since May 2003. Since December 2004 an average of 98,000 daily records has been received into the system.
  • Department of Veterans Affairs treatment facilities – approximately 1,100 VA medical facilities collected since December 2003. Since December 2004 an average of 151,800 daily records has been received.
  • Laboratory Corporation of American test orders – approximately 31 testing locations and 1,100 patient service centers collected since June 2004. Since December 2004 an average of 137,600 daily records has been received.

All of the above data sources include patient age, sex, patients zip code, and facility identifier and zip code.

Once data is received experts from different agencies analyze it and map it to 11 syndrome categories

  • fever
  • gastrointestinal symptoms
  • hemorrhagic illness
  • localized cutaneous lesions
  • rash
  • respiratory symptoms
  • severe illness and death
  • a specific infection
  • botulism-like illness
  • lymphadenitis
  • neurologic signs

Biosense – from the CDC site….

BioSense is the national, human health surveillance system designed to improve the nation’s capabilities for disease detection, monitoring, and real-time health situational awareness. This work is enhanced by providing public health real-time access to existing data from healthcare organizations, state syndromic surveillance systems, national laboratories, and others for just in time public health decision-making. BioSense data are analyzed through advanced statistical methods, and made accessible through the BioSense application. The application provides data, charts, graphs, and maps through a secure Webpage which can be accessed by CDC, authorized state and local public health partners and participating healthcare facilities.

Two examples of the “views” that are available from within the application….

Biosense for Public Health Departments

Patient Distribution MapTime Series

Value to the Public Health Community

BioSense is valuable to the public health community because:

  • It provides simultaneous access to the same data at the same time to all levels of public health;
  • This can decrease delays in recognition of a problem and enhance emergency response;
  • Neighboring public health jurisdictions can share information if they choose to share data;
  • A national system means broader data availability by combining local and national sources; and
  • There is increased capacity for biosurveillance using existing clinical and diagnostic real-time data from hospital information systems.

This is invaluable data that we should all have at the local response level. Not only should we strive to detect initial events within our community but we should utilize all of the tools within our reach in order to have a thorough nationwide situational awareness. Early event detection will be the number determiner of the success of our non-pharmaceutical interventions.

Other CDC sentinel systems

More than 2000 physicians nationwide make up the current CDC sentinal system that monitors trends in influenza like illnesses within cities, states and regions. This system, however, is routed through the state departments of public health. Other systems in place that monitor the nation’s health are the Laboratory Response Network, Health Alert Network, Epi-X, a web based monitoring system, and the new CDC Alerting System, all which aid communication between federal, state, and local health departments and physicians nationwide. Other technology based systems in the CDC’s arsenal are Flufinder, which provides flu vaccine availability information and the Outbreak Management System, which currently assists health officials in four states in managing outbreaks within their jurisdictions. These CDC systems conform to the Public Health Information Network Data Standards (PHIN) which are based on Health Level Seven (HL7) specifications.

We should make use of these systems in the future. I applaud the CDC for developing Biosense and will advocate for its use within my local area. It certainly seems to be our best bet for an early warning system. Kudos to the CDC!

 Related links out
BioSense–a national initiative for early detection and quantification of public health emergencies.
BioSense: implementation of a National Early Event Detection and Situational Awareness System.
Exhibit 300 (BY2009) – PHIN: BioSense, Centers for Disease Control and Prevention
CDC plans BioSense contract
CDC seeks IT services for BioSense


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